P-57 Monitoring quality of life in PLWH using a patient reported outcomes (PRO) and screening tools for emotional and cognitive vulnerability
Notice bibliographique
Résumé
Background Recently, the achievements in treatments of people living with HIV (PLWH) have prolonged life expectancy, simplified clinical management and extended time interval between follow-up visits. Thus, some real-life needs may remain undetected during routine attendance, particularly those related to somatic, emotional and cognitive well-being. To optimize the retention-in-care of PLWH to intercept early signs of somatic, emotional and cognitive vulnerability and impairment, a screening program was conducted. Material and Methods All consecutive patients attending at the HIV/AIDS Unit of the San Gallicano Dermatological Institute in Rome, Italy, were administered: i) the Italian version of the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression vulnerability; ii) a symptoms scale (PRO), derived from the ISS-Quality of Life (ISSQoL) questionnaire, to measure frequency and intensity of symptoms during the previous month; iii) the Italian version of Montreal Cognitive Assessment (MoCA) to screen cognitive functions in seven different domains. Results From January to March 2024, 126 PLWH on ART were screened. Of these, 112 were men (88.9%) and 14 were women (11.1%), with a median age of 53 (IQR=43.25–58.75) and 47 years (IQR=38–58.25), respectively. Demographic and clinical characteristics are reported in table 1. Almost the totality of patients was virologically supressed and immunologically reconstituted. Overall, 35 (27.77%) and 18 (14.28%) reported anxiety and depression levels above the cut-off score, respectively. At the PRO, 64.8% of the patients declared fatigue at different level of intensity, 55.6% sleep disturbances, 51.6% pain, 34.4% decreased sexual interest, 32.5% mental confusion, and 26.1% erectile dysfunctions. Several reported symptoms were associated with emotional vulnerability for anxiety and depression, particularly fatigue, mental confusion and pain (table 2). Forty-five patients (35.7%) obtained a MoCA total score below the cut-off level of 26/30. Poor performances at MoCA screening were not significantly associated with the time of infection adjusted for age (AOR=1.53;95%CI=0.66–3.55; p=0.08) or with emotional vulnerability (Anx: p=0.41, Dep: p=0.59). Finally, fatigue and pain as PRO tended to be reported from patients on dolutegravir-based (p=0.04) and bictegravir regimen, respectively (p=0.004) (table 3). Conclusions A high proportion of PLWH reports recent somatic symptoms associated with a measurable vulnerability for anxiety and depression and over a third of the patients need a deeper neurocognitive assessment. Although these preliminary findings need to be confirmed at the clinical assessment and in a larger sample, they suggest the value of screening tools to intercept measurable QoL discomfort among viro-immunologically reconstituted PLWH.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».